ENVIRONMENTAL 

MONITORING 

PLAN 

 

2009 Rangeland Grasshopper and Mormon Cricket 

Suppression Program 

Prepared by 

Emergency and Domestic Programs - Environmental Compliance 

Animal and Plant Health Inspection Service 

United States Department of Agriculture 

February 2009
2009 Environmental Monitoring Plan 1 

Grasshopper and Mormon Cricket Suppression Program 

GENERAL

The United States Department of Agriculture - Animal and Plant Health Inspection Service Directive 

5640.1 (4/19/02) commits the Agency to a policy of fulfilling the mandates of the National 

Environmental Policy Act; the Endangered Species Act; the Federal Insecticide, Fungicide, and 

Rodenticide Act; and other statutes that require monitoring the effects of Federal programs on the 

environment. The monitoring described in this document partially fulfills these commitments for the 

Rangeland Grasshopper and Mormon Cricket Suppression Program. 

OBJECTIVES 

1. Identify, list and prioritize any sites within or near any program treatment that might have 

human health or environmental concerns. 

2. Demonstrate that operational procedures, mitigations and protection measures were followed 

and implemented. 

3. Collect data which can be used to evaluate whether or not the assumptions used in the 

Environmental Assessment (EA) and Environmental Impact Statement (EIS) are valid 

estimates of potential exposure of the public, program workers, endangered and threatened 

(E&T) species, or other sensitive environmental components, to pesticides used by the 

program. 

4. Demonstrate that pesticides used for all program treatments are correctly identified and are 

accurately formulated. 

5. Conduct investigations of incidents and/or complaints about possible adverse impacts suspected 

of being related to program operations. 

MONITORING METHODS 

Before undertaking any environmental monitoring for the treatment season, contact the 

Environmental Compliance group in Riverdale, Maryland for specific guidance at (301) 734-

8876 or 734-7592 if there are any questions regarding the monitoring plan.

1. Identify, list and prioritize any sites within or near any program treatment that might have 

human health or environmental concerns. 

Prepare a comprehensive list of sensitive sites that are within 500 feet of aerial treatment locations and 

200 feet of ground treatment locations. Sensitive sites are defined as human congregation sites (e.g., 

schools, hospitals, day care centers, prisons, playgrounds, etc.), residences, organic crops, and surface 

water bodies (natural, drinking, or recreational waters). Sites for E&T species are reported based on 

the distances for each species listed in the Biological Opinion and/or Biological Assessment used in 

compliance with the Endangered Species Act (ESA). Each species has a different critical distance to 

treatment sites and those distances are listed under the ‘protection measures’ for the species in the ESA 

documents. Site lists should give a brief description of the site (i.e. residence, type of protected 

species, name of water body, etc.), its location (either address or map coordinates), and its distance and 

direction from the treatment block (direction is always measured from the treatment block towards the 

sensitive site). As part of the Plant Protection and Quarantine (PPQ) Project Planning and Reporting 

Worksheet, information regarding sensitive sites and protected species is provided in Parts A and B of 
2009 Environmental Monitoring Plan 2 

Grasshopper and Mormon Cricket Suppression Program 

the Worksheet. Instead of providing sites lists, only Parts A and B of the PPQ Project Planning and 

Reporting Worksheet need to be provided to Environmental Compliance via email, fax, or hardcopy to 

(though detailed lists are acceptable): 

Kai Caraher, USDA-APHIS, 4700 River Road, Unit 150, Room 5C-03.45, Riverdale, MD 20737-

1237; email kai.caraher@usda.gov; fax 301-734-3308. 

If endangered or threatened species are in a project area, provide the names of the species and the 

protection measures required under ESA consultation that will be used to protect the species. 

2. Demonstrate that operational procedures, mitigations and protection measures were followed 

and implemented. 

Operational procedures, mitigations, and protection measures are detailed in the Grasshopper 

Guidebook Provisional, published January 2008, the Biological Assessment for the program, and the 

site-specific EA developed locally by the program. Copies of EAs and Findings of No Significant 

Impact are not required to be sent to Environmental Compliance. Instead, a copy of the completed Part 

A, PPQ Project Planning and Reporting Worksheet is sufficient to show that such documents were 

completed. If the actual documents are needed, the appropriate personnel will be contacted. 

A checklist is provided on page A1; this checklist serves as self-certification that quality assurance and 

quality control (QA/QC) measures were adhered to for program treatments. A treatment-specific 

checklist will be completed for each treatment and signed by the State Plant Health Director or 

designee, indicating that all QA/QC activities were followed. QA/QC items in the checklist that are 

not relevant to the treatment should be marked as not applicable rather than checked. Significant 

deviations from any procedure should be recorded on separate sheets, along with any corrective actions 

taken, and attached to the checklist. At the conclusion of all program operations for the treatment 

season, send all signed checklists and attachments for each treatment to Kai Caraher for inclusion in 

the Environmental Monitoring Report for the program. States that have multiple treatments may 

submit a single annual checklist rather than separate checklists for each treatment. The checklist has 

been simplified from previous versions, but this does not mean that operational procedures have been 

reduced. Guidance documents detailing operational procedures, mitigations, and protection measures 

are referenced in the checklist, and those details are incorporated into the checklist by reference. 

3. Collect data which can be used to evaluate whether or not the assumptions used in the EA and 

EIS are valid estimates of potential exposure of the public, program workers, E&T species, or 

other sensitive environmental components to pesticides used by the program. 

General Information:

A sampling supplies checklist and order form is provided on pages B1-2. Use this form to ensure field 

personnel have the appropriate number and type of supplies for sampling. This form may also be used 

to order additional supplies from Analytical and Natural Products Laboratory (ANPCL) in Gulfport, 

Mississippi. 

For each treatment, conduct required monitoring for E&T species. Such monitoring is described in the 

Biological Opinion and/or Biological Assessment as ‘protection measures’ for the individual species. 
2009 Environmental Monitoring Plan 3 

Grasshopper and Mormon Cricket Suppression Program 

If a protected species is within the critical distance from a treatment, that protection measure must be 

fully implemented. If monitoring is required under the protection measure, such monitoring must be 

conducted during every treatment near that E&T species site. Some monitoring requires sampling, 

others only buffers or observation. Samples, buffers, and observations must all be documented, and 

such documentation forwarded to Kai Caraher. Contact Kai if any clarification or additional guidance 

is needed. 

For sensitive sites near treatment areas, prioritize the site list as described in standard operating 

procedure (SOP) EM-22, Guidelines for Selecting Environmental Monitoring Sites. (SOPs were 

distributed in prior years and have not changed. If any are needed, they may be obtained at 

www.aphis.usda.gov/plant_health/plant_pest_info/emt/support_docs.shtml). Select the top three 

sensitive sites for monitoring for each treatment. If there are fewer than three sensitive sites, then 

monitor all of them. If there are no sensitive sites, no monitoring is required, and a statement noting 

the lack of sensitive sites for that treatment is to be forwarded to Environmental Compliance. This 

only applies to sensitive sites, not E&T species sites. E&T species sites are always monitored during 

every treatment, following the protection measures described in the ESA documents. 

Dye Cards:

For aerial treatments with liquid pesticides (not carbaryl bait), sensitive sites should be monitored with 

dye cards as detailed in SOP EM-01, Collection of Dye Card Samples. At least one hour prior to the 

treatment, place three dye card stations between the sensitive site and the treatment boundary, directly 

adjacent to the sensitive site (monitor for drift close to the sensitive site, not to close to the treatment). 

Dye cards should be spaced about 30 feet apart. Collect the dye cards two to four hours after the 

treatment. It is critical that the correct type and number of dye cards are used for each pesticide. Use 

one oil-sensitive dye card for malathion or one water-sensitive dye card for liquid carbaryl at each of 

the three sampling stations (i.e. three total cards per sensitive site). Use two water-sensitive dye cards 

at each sampling station for Dimilin treatments (i.e. six total cards per sensitive site). Whenever dye 

cards are used for monitoring, place a blank dye card (negative control of the same type) in the vehicle 

used by the sample collector as described in SOP EM-10. All dye cards are to be submitted to the 

ANPCL with their accompanying documentation. 

Please realize that neither the water- or oil-sensitive cards are marked as such. Dye cards may be 

identified by their coloring; oil-sensitive cards are white on both sides, water-sensitive cards are white 

on the label side of the card and yellow on the sensitive side. If there is any doubt as to what kind of 

cards you may have, put a droplet of water or oil on the sensitive side of one of your cards. The 

droplet that forms the black spotting on the card denotes what kind of card it is. Take care to identify 

and store your cards carefully so that card substitutions are not made when the cards are used. 

If dye cards cannot be collected because of logistical limitations, then an alternate media should be 

sampled after the treatment. Vegetation, wipe, water, or sediment samples should be collected from 

the sensitive site as soon as possible after the treatment, whichever would best characterize the 

potential exposure of the sensitive site being monitored. In some cases, water or sediment sampling 

may be required (see below). 
2009 Environmental Monitoring Plan 4 

Grasshopper and Mormon Cricket Suppression Program 

Sticky Boards:

For aerial treatments using carbaryl bait, sticky board traps will be used for detecting drift. At least 

one hour prior to the treatment, place three sticky boards between the sensitive site and the treatment 

boundary, directly adjacent to the sensitive site. Sticky boards should be erected vertically at each 

station, spaced approximately 30 feet apart, sticky side facing toward the treatment. Collect the sticky 

boards one to four hours after the treatment. Record on an APHIS 2060 form whether any bait adhered 

to any of the three sticky boards, which boards had bait, and the amount of bait particles adhering 

described in as quantifiable a manner as practical. Submit the original 2060 form and yellow copies of 

the form to Kai Caraher. If no bait is detected on any of the three sticky boards, then fill out one 2060 

form for all three sticky boards noting that no particles were observed on the boards. Send both the 

white and yellow copies to Kai Caraher. In either case, retain the other form copies in the local 

program files. No laboratory analysis of the sticky board residues is required. 

Vegetation:

Vegetation should be collected if logistics prevented the collection of dye cards. A single composite 

vegetation sample should be collected from the sensitive site (or as close to the sensitive site as 

practical) two to four hours after the treatment. Grasses are the preferred matrix, but leafy vegetation 

is also acceptable. Enough vegetation (no woody material) should be collected to fill 70% of the foil 

sample bag. Guidance for collecting vegetation samples is provided in SOP EM-07, Collection of 

Vegetation Samples. 

Wipes: 

If dye cards cannot be collected, then wipe samples can be taken from structures or vehicles at human 

congregation sites two to four hours after the treatment. Wipe samples should only be taken from 

smooth hard surfaces such as car windshields, car bodies, and home windows. Guidance for collecting 

wipe samples is provided in SOP EM-24, Collecting Wipe Samples for Residue Analysis. If wipe 

samples are collected, it is extremely important that the area sampled is measured and recorded on the 

APHIS 2060 form. 

Water:

Drinking water sources within 500 feet of aerial liquid treatment, within 200 feet of aerial bait, or 

within 50 feet of ground bait treatment must be sampled before and two to four hours after any aerial 

treatment, regardless of whether or not dye cards samples are collected. If there is rainfall sufficient to 

cause runoff within one week following any treatment, then collect another water sample within 24 

hours after the rainfall. Guidance for collecting water samples is provided in SOP EM-03, Collection 

of Water Samples. Realize that the pH of water samples must be adjusted and stabilized prior to 

shipping. Samples for carbaryl should be adjusted to a pH of 3, malathion to pH 5, and dimilin to 

pH 7. 

If the collection of dye cards (or sticky boards) is prevented because of logistics, then a sample of 

standing water could be collected within two to four hours after treatment. 
2009 Environmental Monitoring Plan 5 

Grasshopper and Mormon Cricket Suppression Program 

Sediment:

If rainfall sufficient to cause runoff occurs within one week of any treatment, then collect a sediment 

sample from natural surface water bodies and drinking water sources within 24 hours after the rainfall. 

Distances of the water body to the treatment block requiring sediment sampling are the same as for 

water samples. Guidance for collecting sediment samples is provided in SOP EM-05, Collection of 

Sediment Samples. 

4. Demonstrate that pesticides used for all program treatments are correctly identified and are 

accurately formulated. 

Each lot of pesticide (neat) and each tank mix (formulated) used for program treatments must be 

sampled. All samples are submitted with either a completed PPQ Form 750 or APHIS Form 2060. 

Forms must: 

• assign each sample a unique identifier, 

• indicate whether the sample is neat or formulated, 

• provide the lot number from which the sample originated, 

• describe the mixing ratio and composition for formulated samples, 

• when the sample was collected, 

• where the sample was collected (i.e. from the nozzle, from the mixing tank, etc.) 

Guidance for collecting neat and formulated pesticide samples is provided in SOP EM-10, Preparation 

of Control Samples and Collection of Pesticide Samples. 

5. Conduct investigations of incidents and/or complaints about possible adverse impacts 

suspected of being related to program operations. 

Promptly investigate problems and/or complaints about possible adverse human health or 

environmental effects. If feasible, collect samples that will help determine if program pesticides were 

a potential cause of the effects. Immediately contact Environmental Compliance in Riverdale, 

Maryland at (301) 734-8876 to collaborate on a sampling plan, sampling methods, and type of 

information to collect. If the incident occurs when Environmental Compliance personnel are not 

available, commence your investigation and sampling without delay, and contact Environmental 

Compliance as soon as possible thereafter. Samples should be collected and shipped as soon as 

possible after the investigation (and freezing of samples) and must be marked as ‘priority’ in box 12 of 

the APHIS 2060 form. Samples should be collected from every matrix appropriate to determine the 

possible cause of the reported effect. However, dead animals other than insects should not be collected 

for safety reasons without first contacting Environmental Compliance. For details, see SOP EM-09, 

Priority (Emergency) Sampling. 

SAMPLE DOCUMENTATION

Draw a clear diagram of the sample locations relative to the sensitive site and the treatment block. The 

diagram should include where each sample is collected, important features (i.e. residences, water 

bodies, roads) identified with labels, and an approximate scale. The sample figures can be created 

either on a Geographic Information System (GIS) map, on a separate piece of paper, or on the 2060 
2009 Environmental Monitoring Plan 6 

Grasshopper and Mormon Cricket Suppression Program 

forms associated with the samples. If you are collecting a series of samples from the same site, submit 

the map and diagram only once, as long as the treatment block and sensitive site and each sample 

location are clearly indicated on the map or the appropriate sections of the APHIS 2060 form. 

Complete a separate APHIS 2060 form for each sample (note that each dye card is considered a 

separate sample, each requiring a 2060 form). Instructions for completing the 2060 forms can be 

found on the back of each form. For each sample; submit the blue copy of the APHIS 2060 form to 

ANPCL with the sample, the white copy to ANPCL in the sample shipping container but separate from 

the sample, and the yellow copy (and any maps, photos, etc.) to Environmental Compliance. For any 

samples that are not sent to the laboratory for analysis (i.e. unspotted dye cards), send only the APHIS 

2060 form to the Environmental Compliance. Keep the pink copy in your local office. 

Properly identify each sample as “routine” or “priority” in box 12 of the 2060 form. An incorrect 

identification regarding the nature of the sample creates confusion for those who must interpret the 

data and delays the processing of samples. Mark samples as “priority” only for instances where a fast 

turnaround of samples is required. This applies to all complaint investigations, spill incidents, 

potential human health issues, and other samples considered to be of very high importance. Otherwise, 

mark the sample as “routine.” 

SHIPPING OF SAMPLES 

Ship all samples using some form of overnight delivery. See SOP EM-17, Packaging and Shipping of 

Samples for details. This applies to all samples, whether they are priority or routine. Do not ship 

samples using the U.S. Postal Service Priority Mail or standard ground service with other carriers. 

Preservation of the samples by freezing requires overnight delivery rather than alternative shipping 

arrangements which are more likely to result in the melting of ice and samples. 

With the exception of neat (pure) chemical, be sure that all samples are frozen, shipped in a cooler box 

(not a regular cardboard box), and kept frozen during shipment. Neat samples should not be frozen, 

but should be placed on ice in a cooler box when shipped. To keep samples cold, use dry ice when 

possible since it does not turn to liquid when thawed and will not ruin forms or samples. Water 

samples should not be shipped in dry ice, since it will cause the sample containers to crack or break. 

Since dry ice may not be available in all areas, regular ice can be used for shipping any samples, but 

only if the ice is placed in a separate sealed container. Either use “blue ice” containers (the reusable 

plastic containers with the blue liquid inside) or contained regular ice (that is, seal the ice in zip-loc 

bags). Unsealed ice will melt and leak during shipment, causing unnecessary concern when received 

at the laboratory and possibly damaging the samples and documentation. 

DISCRETIONARY MONITORING

Additional monitoring samples can be collected at the discretion of program staff. Although the 

monitoring outlined in this plan should be adequate to generate the data needed to meet the objectives, 

the program may decide that additional sampling is necessary around other sensitive areas. Examples 

might include sites where there have been issues in previous years, sites that are highly visible to the 

public or are politically sensitive, or sites where environmental monitoring might help prevent future 

conflicts. Guidance involving any of these cases can be obtained by Environmental Compliance in 

Riverdale. 
2009 Environmental Monitoring Plan 7 

Grasshopper and Mormon Cricket Suppression Program 

RESPONSIBILITIES

APHIS-PPQ Field Personnel or Cooperators, under the direction of the Program Director, will:

a. Ensure that sufficient resources from the program are allocated for completing the monitoring 

detailed in this Environmental Monitoring Plan. 

b. Coordinate with federal and local wildlife officials to identify E&T species and critical habitats 

near or within areas that may be affected by program activities, and inform Environmental 

Compliance in Riverdale, Maryland about any protection measures and monitoring 

requirements. 

c. Implement appropriate operational procedures, mitigations, and protection measures. 

d. Prepare a comprehensive list of all sensitive sites in a treatment program area and document in 

the PPQ Project Planning and Reporting Worksheet. Completed Worksheet Parts A and B are 

sent to Environmental Compliance. 

e. Select monitoring sites for sampling, collect samples, record all relevant environmental and 

sample data, and submit samples to ANPCL for residue analysis. 

f. Submit information describing the sample, sampling site, and treatment to Environmental 

Compliance. 

g. Complete QA/QC checklists for treatment programs. No later than the final treatment program 

within a state, sign and forward all checklists to Environmental Compliance. 

h. Inform Environmental Compliance when priority samples are collected and ANPCL when 

priority samples are shipped. 

APHIS-PPQ Environmental Compliance staff in Riverdale, Maryland will: 

a. Provide training and support for the implementation of this monitoring plan. 

b. Respond to requests for additional information by field personnel when special sampling 

requirements occur. 

c. Review and interpret pesticide residue data. 

(1) If adverse environmental effects are suspected: inform the Program Director and the 

National Program Manager, make recommendations if modifications to program 

operations might be in order, and reinitiate consultation with the Fish and Wildlife 

Service or National Marine Fisheries Service, if needed. 

(2) Send raw data for any priority samples within 1 working day of receipt 

from ANPCL to the environmental monitoring coordinator. 

(3) Prepare a final report within 90 days of analysis of all samples by ANPCL. 

d. Maintain liaison with field personnel to assure monitoring is being conducted and to review 

pertinent documentation for accuracy and completeness. Feedback to field personnel will be 

done in a timely manner so procedures can be modified, if needed. 

APHIS-PPQ Analytical and Natural Products Chemistry Laboratory staff in Gulfport, Mississippi will: 

a. Prepare and ship sampling containers and equipment required for collection and submission of 

environmental monitoring samples. 

b. Provide instructions and training on methods for collecting, preserving, and shipping samples. 

c. Analyze samples for the program pesticides specified on the associated 2060 Form. 

d. Input APHIS Form 2060 data into the database system at ANPCL. Send data to Environmental 

Compliance electronically within 23 working days of sample receipt for routine samples and 

five working days for priority samples.
Send completed checklist to:

Kai Caraher, USDA-APHIS-PPQ, 4700 River Road, Unit 150 – Room 5C-03.45, Riverdale, MD 20737 

 A1

2009 Rangeland Grasshopper and Mormon Cricket Suppression Program 

Quality Assurance/Quality Control Checklist 

The following checklist shall be completed following the completion of a suppression program treatment (or season for 

areas with multiple treatments). When an item listed in the checklist does not apply, leave the box blank. For any 

significant deviations from operating procedures, provide an explanation on additional paper. 

State: Counties/Area Treated: 

Treatment Dates: Total Acres Treated: 

 

Treatment Type (circle appropriate): Aerial Application and/or Ground Application 

 All procedures in the 2009 Guidelines for the Program were followed (they are not included 

individually below). If any item was not followed, such item is noted below or on additional 

paper with an explanation for why that item was not applicable or not implemented. 

Documentation of implementing the procedures in the Guidelines was maintained locally and is 

available upon request. 

 Site-specific Environmental Assessments (EAs) and Findings of No Significant Impact 

(FONSIs) were developed. 

 The public was involved in the development of environmental compliance documents, if 

required by the National Environmental Policy Act (NEPA). 

 Completed ESA Section 7 consultations with USFWS and /or NMFS prior to any treatments, 

and implemented all protection measures as required. 

 Provided a copy of Parts A and B of the PPQ Project Planning and Reporting Worksheet to 

Environmental Compliance prior to the start of project pesticide applications. 

 Implemented the current Environmental Monitoring Plan for the Program. 

 Spill kit was present at APHIS-operated pesticide storage areas. The PPQ Treatment Manual, 

Guidelines for Managing Pesticide Spills was followed at APHIS locations. 

 EPA and State approved label for all pesticides were strictly followed. 

 Current pesticide labels and material safety data sheets were available to program staff. 

 Collected and shipped samples of neat and formulated pesticide to ANPCL for analysis. 

 Documented complaints and recorded visits and telephone calls from the public regarding 

program activities and responses to any complaints. 

 Documented any accidents, safety violations, pesticide spills, and leaks in aircraft systems or 

pesticide storage and loading systems. 

 Weather conditions were monitored and recorded before and/or during applications. Weather 

log completed and on file. 

 Maintained and have on file daily and base logs. Flight paths and spray turn-on and cut-offs 

were monitored and recorded either by direct observation or by downloaded GPS flight data 

overlaid onto a map. 

 The public near treatment areas was notified prior to the application of pesticides. 

_______________________________________________ ___________________ 

Program Director/SPHD/Environmental Monitor Signature Date
Sampling Supply Checklist / Order Form B1 

ENVIRONMENTAL MONITORING SUPPLIES CHECKLIST

SUPPLIES TO BRING EACH TIME YOU GO TO A SAMPLING SITE

Monitoring plan/SOP’s 

Obtain from 

ECT Thermometer 

Field log notebook Ice chest/wet or blue ice 

Obtain 

locally 

Compass Baby wipes 

Wind gauge 2060 monitoring forms 

Indelible marker Packing/strapping tape 

Run-off Sampling Dye Cards

Plexiglas cover Oil sensitive dye cards 

8"x 8" mesh screen Water sensitive dye cards 

Tent pegs/nails 5' bamboo poles/stakes 

Funnels attached to caps Paper/alligator clips 

500 ml bottles Tacks 

4" PVC pipe, 14" long 4" x 4" plastic bags 

Post hole digger 12" x 12" plastic bags 

Pea gravel Tweezers/forceps 

Large rocks/bricks disposable gloves 

Bamboo pole/flagging tape Water Samples

collapsible cubitainer Dissolved oxygen kit 

Sodium sulfate (small vials) collapsible cubitainer 

pH paper/pH meter Sodium sulfate (small vials) 

Sulfuric acid (squeeze bottle) pH paper/pH meter 

Styrofoam ‘coffin’ Acid or base (squeeze bottle) 

Obtain 

locally

Vegetation/Fish/Insect Samples Sediment Samples

Pruning sheers/scissors Dredge tied to strong rope

Aluminum foil envelopes 3 gallon galvanized pail

Strapping tape Hand trowel

3" mesh screen

 Aluminum foil envelopes
Sampling Supply Checklist / Order Form B2 

Soil Samples Swab/Wipe Samples

Soil core sampler 3” x 3” sterile cotton pads 

with resealable plastic bag 

3 gallon galvanized pail Metric ruler 

Hand trowel Pencil 

3" mesh screen Disposable gloves 

Aluminum foil envelopes Isopropyl alcohol Obtain 

locally

Baby wipes 

Neat (Pure) Chemical Formulations Miscellaneous Supplies

Amber glass bottle Labels 

Parafilm Styrofoam coolers/mailers 

Small mailing tubes Freezer 

Obtain 

locally

Cat litter/packing material Dry ice 

Obtain 

locally 

Disposable pipette Resealable plastic bags: 

Pipetting bulb 4" x 4" 

Disposable gloves 6" x 6" 

Protective eyewear 8" x 8" 

 12" x 12" 

Program: _________________________________ Requested by: ______________________________ 

Date: _____________________________________ Phone: ____________________________________ 

Address: ____________________________________________________________________________________ 

____________________________________________________________________________________________ 

____________________________________________________________________________________________ 

To order supplies, indicate the quantity of each items needed. Fax a copy of this form to ANPCL at 

228-822-3209 or 228-822-3137. If fax machines are not working, leave a message with the ANPCL supplies 

manager at 228-822-3106. Please realize that it may be difficult to completely fill order for large quantities of 

materials. 

Note: This is not an exhaustive supply list...items that are not listed here may be available through ANPCL.